Introduction and Acknowledgments
When we three, Valerie, David, and William, decided to undertake this project 3 years ago, we knew that it was going to be a major undertaking. Tumours of the Upper Jaw had been published by Valerie with Professor Sir Donald Harrison (Fig. 1.1) in 1993 and in the intervening period there had been a significant number of changes in the evaluation and management of tumors in the sinonasal and nasopharyngeal areas. Unfortunately, tumors in these areas still present late and their cure provides huge challenges. In addition to our own substantial experience, we have conducted an extensive review of the literature to identify all significant contributions since the last book and have tried to use the best evidence available.
We recognize that level I or II randomized placebocontrolled trials are absent in the literature for virtually any treatment used for these tumors due to a combination of ethical considerations and the rarity of the conditions. Even the acquisition of large prospective cohorts of tumor patients has proved difficult, although there are now several centers, including our own, that have published data that are adequate for statistical analysis. Nonetheless, there are a large number of pathologies that are represented only by case reports or small retrospective series. It is also worth noting that journals willing to publish these types of report are now few because of the pursuit of scientific credibility and improved impact factors. Thus it may become increasingly difficult to gather information on the rarest pathologies but this situation also supports the view that there should be a degree of centralization of many sinonasal, skull base, and nasopharyngeal neoplasms. This is particularly underlined by the proliferation of endoscopic techniques and has led to the development of collaborative multicenter networks and prospective data collection.1 Along with accurate records of long-term follow-up, this will greatly facilitate future evaluation of results. Similarly, the majority of the tumors covered in this book are now managed by multidisciplinary teams which include input from neurosurgeons, ophthamologists, plastic and maxillofacial surgeons, radiation oncologists, and a range of other experts.
We have included a few additional clinical conditions that strictly speaking do not come under the definition of neoplasms but are difficult to manage, may mimic tumors, and at times are life-threatening in their own right.
While odontogenic tumors are normally the province of oral pathologists, oral surgeons, and maxillofacial surgeons, they are also seen and treated by ENT and plastic surgeons in many parts of the world and accordingly have been included.
In undertaking this project we have been helped by a large number of individuals, not only through the excellent contributions from Professors Zinreich, Ang, Chua and their colleagues but also from friends and coworkers. This list is by no means complete but we would like to thank our long-suffering secretaries, Angela Constantinou, Trisha Holness, and Anne Oliphant; colleagues including Tim Beale, Lloyd Savy, Gita Madani, Anne Sandison, Peter Clarke, Dawn Carnell, Simon Stewart, Richard Welfare, Geoff Rose, and other colleagues at Moorfields; and Fellows and trainees Humera Babar-Craig, Ed Chisholm, Jo Rimmer, Adin Selcuk, and Matteo Trimarchi.
Finally we would like to pay tribute to several individuals whose unique clinical expertise and support have enormously enhanced the treatment of our patients: Tony Cheesman, Sir Donald Harrison, Glyn Lloyd, Leslie Michaels, and Margaret Spittle (Figs. 1.2, 1.3, 1.4, 1.5).
Reference
1. Lund VJ, Stammberger H, Nicolai P, et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 2010;(22):1–143
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